Sunday, July 21, 2002

Over the past few weeks important issues have evolved regarding Biodefense. There is a major struggle going on in the Congress about the formation of the new Department of Homeland Security (DHS). At issue (among other important issues) is whether the $1.748 billion that is in the President’s budget for FY2003 will be transferred over to the new DHS and who will actually be responsible for the strategic plan and prioritization for biodefense. DHS people (Gov. Ridge and Richard Falkenrath) clearly state that they want the money and the responsibility, but that they will work very closely with me. The Congress and all of the scientific Societies (FASEB. ASM. Etc.) say that they want the money and prioritization with me. As usual, I must publicly defend the President’s position, but I work behind the scenes with people like Sens. Lieberman, Kennedy, and Frist to get language in the new authorizing Bill that will not transfer the money or responsibility (let us see what actually happens). Meanwhile, VP Dick Cheney is pushing for a Manhattan Project approach to Biodefense. He mentioned this at his visit to CDC and told Julie Gerberding that he would mention this to me also. Of note, I was quite influential in supporting Julie for the CDC job. We have CIA intelligence that Iraq has smallpox and everyone in DHHS and the WH are scrambling to get together an immunization plan that will go well beyond what the ACIP is recommending (i.e. pre-emptively vaccinate only about 10,000 – 20,000 health workers and rely on ring vaccination in the event of an attack). Cheney is pushing for a much wider vaccine plan. TGT will present our plan to Cheney within a few days, which recommends a staged (1,2,3) process that vaccinates about 500,000 health workers from Oct. 02, to December 02 and then from Jan. 03 through the end of 03 vaccinate up to 10 million responders (phsyicians, nurses, police, firefighters, EM people, primary care personnel). After that and depending on the adverse event rate and the perception of threat, we will make vaccine available for the entire USA population on a voluntary basis. One of the reasons for the push by Cheney is that he knows that Iraq has smallpox and he is planning to push out Sadam Hussein either by direct invasion of Iraq or by funding the opposition. He is afraid that Sadam will strike Israel or even us if his back is against the wall. There will be very intense discussions over the next couple of weeks with the WH and DHHS that involve me regarding smallpox vaccine policy. Things are obviously very busy with my being involved simultaneously with Biodefense and International response to HIV/AIDS. Both of these involve my direct interaction with the White House. July 22-24, 2002 - Went to the beach (Beach Haven) to link up with family. In the car on the way up and while I was there, I spent considerable time on the phone trying to work out with Sen. Spector’s staff (Bettylou Taylor et al) language in the Lieberman Bill on authorization of DHS that Spector could support. They want to make sure that I am comfortable with the language. I am trying to get language that give DHS ultimate lead in the overall prioritization of the research on biodefense, but the money stays in DHHS and the research is executed by NIH, but the development of the research agenda in done by DHHS in consultation with DHS. Finally we had a conference call (I took it in the kitchen of the beach house) among me, the White House (Richard Falkenrath) and the Senate staff that are marking up the bill. Richard and I agreed upon what I listed above. Hopefully, the bill will get through with that language. It was important to have the WH on the phone since I was getting concerned that they might think that I was undermining their efforts to get the DHS going. By hashing it out with them, we are doing it up front and honestly.